Dementia Patients Have Highest Hospitalization Rates, Most Preventable Conditions

A new study shows people with dementia have a higher rate of hospital admissions, but are also more able to prevent hospitalization through proactive care.

The study was conducted by the University of Washington, Seattle, and published in the Journal of the American Medical Association.

Their research showed that compared to people without dementia, those who suffer from cognitive impairment have a higher rate of hospital visits and ambulatory care-sensitive conditions (ACSC), which may have been prevented through preventative health visits to their doctor.

Dr. Elizabeth A. Phelan, of the University of Washington, Seattle, and her colleagues, created a study to show whether dementia onset is associated with increased rates of hospitalization, specifically for ambulatory care-sensitive conditions.

They focused on 3,019 participants in Adult Changes in Thought (ACT), which is a longitudinal study that follows adults over age 65 to identify risk factors for cognitive decline with aging, and the results were evident.

Out of the participants, 494 individuals eventually developed dementia, and 427 (86 percent) of these persons were admitted to a hospital at lease once between 1994 and 2007; 2,525 remained free of dementia, and 1,478 (59 percent) of those were admitted at least once during the same period.

Total admissions were 5,328. Among those who developed this condition, there were 689 admissions prior to diagnosis and 714 after they were diagnosed with dementia.

Out of those in the group who were of ACSC admission, 121 occurred before dementia diagnosis and 198 after. 40 percent of those who had dementia had at least 1 ACSC admission, in comparison with 17 percent of those without it, making the average annual admission rate for those people with dementia more than twice more for those who didn’t suffer from it.

“Noneelective hospitalization of older people, particularly those with dementia, is not a trivial event,” said the authors of the study.

“Identifying conditions that precipitate hospitalization of elderly individuals with dementia could focus clinical priorities on secondary and tertiary prevention in the outpatient setting and improve health care for this vulnerable and increasing population,” they wrote.

Dementia is a loss of brain function that happens when patients develop certain diseases, such as Alzheimer’s. Researchers also learned that proactive doctor visits can eliminate many of the causes that force patients to undergo hospital or emergency room treatment.

In Addition the study found that bacterial pneumonia, congestive heart failure, and urinary tract infection, accounted for two-thirds of all potentially preventable admissions.

“Admission rates for dehydration and duodenal ulcer, though low overall, were also significantly higher among those with dementia,” the authors stated.

Researchers also stress the importance of knowing which ambulatory care-sensitive conditions are most likely to lead to hospitalization, in order to give the right diagnosis and begin preventative treatment.

“Early detection and outpatient management of acute illness when it is still in its early phases might minimize the need for hospitalization for these conditions and help health care organization reduce their rates of admissions for ambulatory care-sensitive conditions, and associated costs”, they said.